A retrospective observational study on characteristics, treatment patterns, and healthcare resource use of patients with myasthenia gravis in England

Jordy van Enkhuizen; Jean Binns; April Betts; Fatemeh Saberi Hosnijeh; Myriam Alexander; Mark McCormack; Saiju Jacob

doi:10.1177/17562864241237495

A retrospective observational study on characteristics, treatment patterns, and healthcare resource use of patients with myasthenia gravis in England

Ther Adv Neurol Disord. 2024 Apr 16:17:17562864241237495. doi: 10.1177/17562864241237495. eCollection 2024.

Authors

Jordy van Enkhuizen¹, Jean Binns², April Betts², Fatemeh Saberi Hosnijeh³, Myriam Alexander⁴, Mark McCormack⁴, Saiju Jacob⁵

Affiliations

¹ UCB Pharma, 216 Bath Road, Slough, Berkshire SL1 3WE, UK.
² UCB Pharma, Slough, UK.
³ Real-World Evidence, Modelling and Meta-Analysis, OPEN Health, Rotterdam, The Netherlands.
⁴ Real-World Evidence, OPEN Health, London, UK.
⁵ Department of Neurology and Centre for Rare Diseases, Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham, UK.

Abstract

Background: There are limited data on the real-world healthcare resource use (HCRU) and management costs of myasthenia gravis (MG) in England.

Objective: This study aims to assess the burden of disease for patients with MG in England.

Design: A retrospective, observational cohort study of adult patients diagnosed with MG, using data from the Hospital Episode Statistics data warehouse.

Methods: Patients with a first-ever recorded diagnosis of MG between 30 June 2015 and 30 June 2020 were followed up until 30 June 2021 or death, whichever occurred first. Post-diagnosis patient characteristics, treatment patterns, HCRU, and costs were described. Costs were evaluated using National Health Service reference costs.

Results: A total of 9087 patients with a median follow-up time of 2.9 years (range, 1.7-4.3 years) were included. The mean age at diagnosis was 66.5 years and 53% of the patients were male. A large proportion of patients (72.8%) were admitted as inpatients during follow-up with a mean number of 1.3 admissions. Patients hospitalized for MG-related complications spent a mean of 9.7 days per patient-year in the hospital. During follow-up, 599 (6.6% of the total cohort) and 163 (1.8%) patients had a record of rescue therapy with intravenous immunoglobulin (IVIg) and plasma exchange (PLEX), respectively. Rituximab was administered to 81 (0.9%) patients and 268 (2.9%) patients underwent thymectomy. In those patients receiving rescue therapy or rituximab, >10% received at least three cycles of the same treatment. The average annual cost of hospital admissions across all patients treated with IVIg, PLEX, and rituximab were £907,072, £689,979, and £146,726, respectively.

Conclusion: A majority of MG patients required hospitalization or accident and emergency attendance, resulting in high HCRU and costs. A subset of patients required rescue therapy (including IVIg and PLEX), rituximab administration, ventilation, or thymectomy.

Keywords: England; costs; hospital; immunoglobulin; myasthenia gravis; resource use.